Does migration, deprivation change at the area level, or social mobility influence health inequalities within the population?

Inequalities in health are well documented. But it is less clear why inequalities between people and places change over time. One mechanism that may contribute is the redistribution of differently healthy people between locations, area types or social classes. 

Though the relationship between these highly inter-dependent mobility processes, the resulting socio-spatial trajectories, and health inequalities is widely explored, conclusions vary. This, in part, is due to the different approaches employed. 

For example, modelling individual-level outcomes – a common approach – reveals the relationship between particular socio-spatial trajectories and health outcomes. Yet it does not reveal the influence on health inequalities at the population level. There may be a strong implication that differences between groups may affect either area or class relationships, but this is not specifically measured. 

A more appropriate framework of analysis must establish three key questions to determine the relationship between socio-spatial trajectories and changing health inequalities. Specifically:

  • To what extent do health gradients vary when populations are able to move between area types or social classes compared to those arising when populations are put back into their area type or social class of origin? 
  • To what extent does the health status of those entering the most and least advantaged areas, or highest and lowest social classes differ from those leaving these areas or classes?

And finally, given the inter-relationships between opportunities for migration or residential mobility and social mobility,

  • To what extent does the patterning to health by transitions into and out of differently deprived areas or social classes vary migrant status? 

Using data from the Office for National Statistics Longitudinal Study, we demonstrate three methods that collectively reveal whether and how different socio-spatial trajectories can contribute to changing health inequalities at the population level. Our framework offers insights into the nature and extent of inequalities within population, identifying mechanisms that can contribute to changing inequalities while also illustrating differences in opportunities for and nature of social or geographic mobility. 

Future work, in combination with this framework, must examine the complex interplay between people, places and politics to better unpack the injustices in uneven opportunities for social or geographic mobility, particularly where this contributes to widening health inequalities. 

To learn more, see our open access paper published by Population, Space and Place: ‘Establishing a framework of analysis for selective sorting and changing health gradients’, Frances Darlington-Pollock and Paul Norman https://doi.org/10.1002/psp.2359

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Looking to University this Autumn?

“Your studies may have been disrupted, but the opportunity to engage critically with geographically relevant issues has not”

I share my thoughts and some advice for all aspiring Geographers who have faced significant disruption to their studies over the past three months. Whether it is a few months or a few years before you begin your academic career, you might find this post useful!

https://geographical.co.uk/opinion/item/3728-a-message-to-new-geography-undergads-from-a-university-lecturer-in-this-time-of-crisis-there-is-opportunity

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Older people in England: the geography of challenges and opportunities

**New Research**

The COVID-19 pandemic has illuminated openly ageist discourses which not only negatively impact on older people, but also highlight a frequent failure in policy approaches and public narrative. Old-age is too readily equated with dependency, frailty, and vulnerability, ignoring the diversity of experiences within the older population, both in capability and need. As the population ages, it is ever more critical that we better understand variation in characteristics, behaviours and needs within the older demographic, and challenge ageist discourses.

Funded by The Nuffield Foundation, this project will develop an open access, multidimensional classification of the older population in England at a small area level, enabling more effective service planning and policy development.

We will produce an online open access platform visualising the geodemographic classification of older people in England. This tool will classify areas according to different characteristics of the older population. It will capture information on demographics, socio-economic status, health, consumption pattern and digital use. It will also capture information on pertinent features of the local built and natural environment.

The project will produce an online open access platform visualising the geodemographic classification of older people in England, including interactive maps and pen portraits of the identified clusters.

The project will take place across three work packages: creating the geodemographic classification, ground-truthing, and applying the classification. It will provide a robust account of the social and spatial stratification in the older population nationally, and demonstrate the importance of understanding this stratification for policy. In this project, we will be working with local stakeholders including Liverpool City Council and the Liverpool City Region Combined Authority to showcase how the purpose built classification of older people can support policy development, service planning and retail provision to better meet the needs of our local older population. 

If you are interested in knowing more, please follow my ReseachGate page here; or contact me on f.darlington-pollock@liverpool.ac.uk.